The results of an online survey have shown that a staggering 54% of doctors agree with the principle of refusing medical treatment to smokers and obese people. The basis for the proposal is that the potential benefits of treating these patients are outweighed by the likelihood that the procedures will be ineffective due to their lifestyle.
The poll on doctors.net.uk was optional and just over 1,000 doctors filled it out, with more than half answering in the affirmative to the question: 'Should the NHS be allowed to refuse non-emergency treatments to patients unless they lose weight or stop smoking?'
Not only does this completely contradict the essence of the Hippocratic Oath and the indiscriminate values of the NHS, but it opens the floodgates for refusing treatment to anyone who is suffering from a self-induced or avoidable condition or injury.
Some private health providers have already begun to deny funding for certain treatments to patients who smoke or are obese, as is their prerogative. To do so on the NHS, however, would risk setting a precedent which effectively means that you are not deserving of treatment if you could have avoided your condition but chose not to, or if your chances of surviving are lower than average.
By following these rules, patients should not be treated if they are alcoholics, drug addicts or suicidal. Neither should we treat anyone whose injuries were sustained in prison, women in a long-term abusive relationship, or elderly people whose life expectancy is relatively low.
The unspoken issue is that of the cost of treating these conditions, which has often been associated with the possible future collapse of the NHS. The study may choose to ignore the financial implications, but whilst we’re on the subject, here’s another thought: Should smokers and obese people be exempt from paying national insurance seeing as they will not be entitled to reap its benefits?
Many overweight people and smokers with health conditions relating to their lifestyle choice are aware of the damage they are doing to their bodies, so perhaps it would be worth examining the emotional factors linked to their inability to stop indulging in the habits which have caused their health problems.
By suggesting that it would be a good idea to alienate a section of society to such an extent that their basic human rights are being violated, the message these doctors are sending is that medical treatment is not a right, but a privilege which has to be earned, and where an abstract morality prevails in order to decide who is entitled to it.
It is also worth noting that it is not illegal to smoke or to be obese, whereas the use of recreational drugs and drunk driving cause a number of conditions and injuries which are treated by the NHS free of charge and jusgement. Surely if we start to legislate who can and who cannot receive medical treatment, those who are reckless with their health and displaying criminal behaviour should be the first to be penalised?
It is not within a doctor’s remit to withhold treatment in order to blackmail a patient into losing weight or stop smoking and if this is the only solution they can think of then perhaps our GPs should be better equipped to make their patients aware of the risks and treatment options available to them.
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